Why the Rich Live Longer

One of the great mysteries of modern medicine: Why do rich people live longer than poor people? Why is it that, all around the world, those with more income, education and high-status jobs score higher on various measures of health? As stated in a World Health Organization pamphlet: "People further down the social ladder usually run at least twice the risk of serious illness and premature death of those near the top."

[...]

But today the major threats to health are chronic diseases--which, inescapably, require patients to participate in the treatment, which means in turn that they need to understand what's going on. Memorable sentence in the Gottfredson-Deary paper in the February 2004 issue of Current Directions in Psychological Science: "For better or worse, people are substantially their own primary health care providers." The authors invite you to conceptualize the role of "patient" as having a job, and argue that, as with real jobs in the workplace, intelligent people will learn what's needed more rapidly, will understand what's important and what isn't and will do best at coping with unforeseen emergencies.

As most people know, noncompliance (e.g. failure to take medication as prescribed) is a major problem in health care; it's a factor in antibiotic resistance as well as accidental overdoses and so forth. The paper argues that noncompliance isn't only due to lack of motivation, but also lack of understanding - patients just don't know what they're supposed to be doing.

This topic pushes my idealist buttons - I've always thought that doctors need to be effective teachers, and hoped that I'll be able to. Surely, given time and patience, education will work. Right?

# : 12:24 PM : :

The vacation was fun. We did San Francisco, Lake Tahoe, and Yosemite in just over a week - rather a whirlwind tour. I'll probably post my trip report here once I type it up.

So now I'm back, jetlagged and headachy. Luckily not too much stuff popped up while I was gone, so I get to relax a bit.

Apartment update: Last week (I guess actually two weeks ago), I did apply at the across-the-street apartment, and set up a move-in date of August 4. So I extended my current lease a few more days. I also got on the waitlist at the nicer place. Last night I had an email from the nice place saying they had an apartment for me - ack! I couldn't decide - the rent was about the same, the nicer place didn't have quite as good a location (farther from Metro for K) but it did have a fireplace, two bathrooms, and balcony. They waived the fees due to a preferred employer program.

I still hadn't made up my mind when I called them this morning, only to find the apartment had been rented since they couldn't contact me (I think they probably tried me at work on Friday). I considered staying on the waitlist, but they said the pet fees/rent won't be waived, and I'm dead set on getting kittens, so the across-the-street one will be a better deal. And more convenient for K, despite having only one bathroom and no balcony. I'm pretty happy with how things turned out.

Other updates: I never did get my emissions check finished. I tried to call the Mazda dealer to see if they can do that and an oil change this week, but I got disconnected - their phones there suck. This annoys me. I've gone to the gas station next door three times and been turned away each time, and can't get through to the dealer. I'm supposed to have this done by the end of June. At least my Ohio plates don't expire until August, so I guess I can keep them on for awhile longer.

I will be in Cleveland this weekend. As always, call me if you want to hang out.

# : 10:13 AM : :

Tomorrow morning I leave for San Francisco at the ungodly hour of 5 AM. It's pretty unlikely that I'll be updating until I get back next Sunday. Have a good week!

# : 1:27 PM : :

I'm trying to get a lot accomplished this week.

I submitted AMCAS yesterday. I don't feel as relieved as I thought I would, probably because once I got the final edits to my essay (thanks Tim!) and my MCAT scores, I was feeling pretty satisfied already. But it is nice to have it in. I might still do a little more research into schools and add one or two, but basically now I just wait for secondaries.

After work yesterday I went and filled out an application at the apartment complex I like best, so now I'm on their waitlist. After touring, I definitely like the place, but I'm not so thrilled about the high pet fees. We'll see if I get in.

I also went to the gym (I could only do a short workout since I was wiped out from not sleeping much, but it still counts!) and mixed up possibly the tastiest post-gym dinner ever: black beans (canned), corn (frozen), salsa (jarred), over brown rice, with mexican cheese. This was Rachel's idea, and it's yummy. I have leftovers for tonight, yay!

This morning I tried to get my car inspected, since I have to before July, but their inspector was injured and their emissions machine was broken. Maybe it'll get done tomorrow.

Tonight hopefully I'll apply at the apartment complex across the street from my current one. I wasn't so excited about them, but they do have free pet rent. And the location is good. My plan is to put down a deposit on an apartment, but not sign a lease unless/until I hear back from the other place. So I'll know I won't be homeless but I'll still have my options open. This is my P and J sides struggling.

Still this week I have to do laundry and pack for next week's trip. This shouldn't be hard, since mostly we'll be driving and touristing and thus I can live in jeans and t-shirts, but I want to look cute in the pictures.

# : 9:49 AM : :

I have three more gmail invitations. First come, first served.

Today I love gmail even more than ever. The conversation feature is so cool - I sent an email to both my parents telling them about my MCAT scores, and each of their replies shows up in the same conversation. So convenient. I'll have to try having a more complex multi-person conversation, to see if they've come up with some magic way of dealing with the confusion that inevitably results.

# : 10:00 AM : :

Not only did I do better than I expected, I did better than I even hoped. Wow.

# : 12:08 AM : :

This weekend was one of the best I've had since moving here.

I took a sailing class with three friends from work. Saturday and Sunday, 9:30-3:30, we were on a 19' Flying Scot. Saturday was a gorgeous day for picnicking, not so much for sailing - it was sunny and calm. We mostly floated around in the bay and got sunburned.

I did wear sunblock, but did a really crappy job of applying it, so I have blotches of sunburn on my chest and thighs, and one hand-shaped one on the back of my shoulder. Also I burned the top of my head (perhaps my hair is thinning?) and my lips. The head one is the worst, because it hurts when I brush my hair.

Anyway, that day we didn't eat lunch because we were hoping to sail down to Old Town Alexandria to eat, but then the wind didn't cooperate, so I didn't get any food until we went to Five Guys afterwards. I know Five Guys is supposed to be the best burgers in town, but personally I don't think anything can beat home-grilled. Especially because they gave me tomatoes instead of pickles.

Sunday was much better for sailing, overcast and windy. The water was pretty choppy, and we got sprayed a fair amount. My fingers were numb by lunchtime. But for me, cold and windy's probably better than hot and windy, because I don't think I can be seasick and cold at the same time. Being overly warm definitely increases the risk of nausea (as my scuba diving buddy knows - at least I've never puked ON her).

So we sailed down to Alexandria, did some practice maneuvers, and docked the boat at the seawall while we strolled up to get pizza for lunch. Taking a boat to get food is one of the great pleasures in life, I have to say. Then we sailed back and it was my turn at the tiller to practice maneuvering. Being a control freak, that was naturally my favorite part. And I didn't stink at it, at least no worse than anyone else. So now I'm a certified sailor and I can add another "sport" to the list that I like.

Also on Saturday I went to a party at Tim's. Thanks to a march at Dupont Circle and the corresponding closed roads and traffic, I was rather late so stayed until 2AM to make up for it. I may be paying for that all week. But I had a fantastic time, met a bunch of cool people (including a fellow CS/German geek, with whom I conversed auf Deutsch, or at least listened to him speak German since mine isn't that great), and danced quite a lot after Tim finally convinced me to. And, they had good drinks so I got to have gin and tonics and a whiskey sour (which I don't think I mixed right; it didn't taste as good as I remembered). Overall an excellent evening.

Of course I got nothing useful accomplished over the weekend, so now this week I have to get my car inspected, find an apartment, and do laundry and pack for next week's trip to San Francisco.

# : 2:42 PM : :

I'd been looking forward to this movie, mostly because it's about a bunch of Christian high school students which is a topic I know pretty well from experience.

At first I didn't get all the jokes, because some of the cliches were so right on (hand-waving prayer) that I didn't realize they were meant to be funny, but others weren't really close enough to be effective satire. But it came together pretty quickly, and a lot of the lines were really funny, much more so than just showing cliches.

The acting was impressive. Jena Malone is great as the girl who gets pregnant trying to cure her gay boyfriend. Her performance, after the first several minutes at least, was very effective. Mandy Moore overdid it as the Pharisee-like most popular girl; she would have been more effective if they hadn't hammered the self-righteousness and insincerity quite so much. (Also, her hair and makeup were atrocious. Normally she's attractive, but in this movie all the other cute teenagers outshine her.) Eva Amurri, the rebel Jewish girl, is hilarious.

The big shocker was Macaulay Culkin, who plays Mandy Moore's crippled brother. He really can act, and he makes his wheelchair-bound character fascinating and sexy - and funny, with great timing for his wry jokes. It's not often that I wish I could know a movie character in real life, but I really wish I could meet Roland.

I already mentioned that the beginning didn't work that well for me, and the ending isn't great either (I was slightly reminded of Carrie, and the resolution is too sappy, I'm OK-you're OK for me). The majority of the movie, though, was funny and touching.

I'm still trying to decide whether this movie's treatment of Jesus-freak* teenagers is mocking or gentle teasing. I guess I'd have to say it pushes the line. I wished it had been more thoughtful and less heavy-handed - it still could have been just as funny. But on second thought, they might have meant it as a teen movie, in which case it's far above most. I recommend it.

*I mean this in the reclaimed sense, as in the song "Jesus Freak" by the Christian rock band dcTalk.

# : 11:23 AM : :

Yesterday evening I went and got dinner and a movie with one of my co-workers. It was fun, just what I needed after the disappointment of hearing from the jerky townhouse owners.

We went to Shirlington, where I found the DC location of Aladdin's! I knew there was one around there (my dining companions might recall me shrieking in joy when I saw "Arlington, VA" under the locations list last time we ate in the Cleveland Heights location) but I'd never gone looking for it because I assumed traffic would be horrible on Friday night which is when I always crave Aladdin's. Thursday night traffic wasn't bad at all, though, so I will definitely go back there.

However, we skipped Aladdin's (I didn't feel that much like garlic) in favor of Indian food at Aromas, next door. I was happy because my friend is pretty knowledgeable about restaurants so usually I feel like a hick, but he didn't know much about Indian so I got to explain the menu to him, and he was impressed that I was able to tell him what almost everything was. (Thanks to Anand for taking me to Indian so much during college!) He got lamb vindaloo, which I warned him was going to be spicy. He ate most of it, which was more than I could've done - the two bites I had were so hot they gave me hiccups. My lamb hydrabadi was so tasty that I could have eaten the sauce with a spoon (I didn't actually).

Then we got tres leches cake across the street. I'd never had it before, and it was yummy but I am happy with chocolate.

I'm going to put my movie review in the next entry.

# : 10:47 AM : :

I heard back from the owners of the house we were hoping to rent. We're not going to get the house, because someone else offered to pay first and last months' rent up front, so they accepted that offer even though we'd already scheduled an appointment with the realtor to sign paperwork because they didn't think we would be able to match that. They could have asked - I could actually afford that.

Apparently trying to rent a house with two other roommates makes one appear poor. I'm not poor, I'm just stingy. And trying to help a friend out.

I did tell the realtor, while setting up the credit check, how much my other employed friend and I make, to which her response was "wow, I guess you're richer than I thought!" She must not have passed on that little tidbit to the owners.

God damn it, I have money! I can pay my bills! I am a grownup!

I'm not a very good grownup though, because I'm definitely going to cry at not getting the so-cute house we wanted so much.

# : 5:26 PM : :

I had a good time last night. We went to a place in Arlington called Gua-Rapo and got tapas. There were two vegetarian ones, one chicken, and one salmon, with various cornbread or salsa or fried plantain accompaniments. The non-vegetarian ones were a little dry, but all were definitely yummy. I drank "sangria verde" which was incredibly delicious. I might have to go back just for that. (I'm not sure why it was called "verde" - doesn't that mean green? It was white, or light orange at any rate.)

The problem with the restaurant was the lack of air conditioning. (I do realize that this comes right after my post complaining of the cold in my office.) We were all sweating like crazy, so we went to the Irish bar down the street for dessert and Guinness. I don't think the Irish are known for their desserts, but my chocolate cake was good. And chocolate totally goes with Guinness.

# : 3:16 PM : :

Damn it, I really need to learn to deal with the temperature in my office.

It's freaking cold in here. Both our thermometers (the one on the thermostat, and the one my boss brought in for verification) consistently read 69-71, and there's a chilly draft. It used to be that the thermostat read 76 most of the time, and we complained that it was clearly wrong, so they moved the it to a more central location. Now the thermostat knows the real temperature, but even though we have it set to 74, it still stays cold. You'd think that with people and electronics, it'd get warmer but we're obviously getting cold air from somewhere.

When I complain, I get non-answers: "it depends on how many people are in there" ... "just give it a minute" ... "set the thermostat higher" ... no, the fact is, the thermostat only works in the down direction. The number-of-people argument would make sense if the problem were a too-high temperature. But as it is, I suspect that they just have the A/C units set to run all the time, or to listen to some other thermostat, because otherwise there would be no cold air coming in here while the thermostat is set above the current temperature.

It frosts me that our thermostat doesn't work. It really, really does. If it were just cold, I could deal better I think, but the fact that there are A/C units with purportedly working thermostats makes it worse. This reminds me of how, in high school, if you complained about the way things were, they'd tell you to run for student council - which is a stupid suggestion because first, you'd have to win, and second, student council has no power anyway. The dangling of pseudo-power makes the powerlessness that much more frustrating.

The combination of constantly being cold and feeling impotent to change it is having very bad consequences. I'm attaching way too much importance to this and allowing it to make me grumpy. I think I am already known as "Amanda who's always pissed off about the thermostat." So I need to learn to accept the situation calmly, and just deal without complaining. But it's such an easy target, and being cold is so unpleasant. Maybe I should take up meditation.

# : 3:30 PM : :

This house thing is stressful. I'm trying not to get my hopes up too much, but I do really hope we get the place. That's all the worrying I'm going to write though.

Today I went to the gym before work since I didn't think I'd feel like it after. I'm going to try to make a habit of this, as long as I can get up early enough. Since I only did the elliptical machine and no weights, I don't feel all wiped out.

Extra cardio is part of my attack on high cholesterol. I'm also trying to modify my diet to be healthier without having to eat all rabbit food, because really, what's the point of living longer if you can only eat salad your whole life? So last night I went to TJ's and got turkey sausage and plain cheerios and dried strawberries. I planned to cook chicken with tomato sauce, and veggies with pesto sauce, but I discovered after getting home that my mushrooms had gotten slimy. So instead I made comfort food: smoked sausage with barbecue sauce, over brown rice as a nod to health. I know it sounds disgusting, but it's really good.

Tonight I'm going out to a trendy bar. It's supposed to be good. I am still skeptical about the bar thing, but maybe it'll be fun.

# : 2:08 PM : :

My trip to Cleveland was very nice. I got to see the new Harry Potter movie (not as much fun as the first one IMO but then I didn't get to revel in the anticipation as much), see several friends, and go to my grandpa's surprise 80th birthday party. That was great. I was sore for two days from chasing and wrestling with various small children - clearly I don't get to do enough of that!

Several little girls drafted me to be their wiffle ball pitcher. It's kind of funny, I sucked at sports as a kid and still do now, but apparently at some point I got big enough that I'm at least better than the little kids. Woo, accomplishment! Anyway, I still can't pitch a wiffle ball well enough to stand at a normal distance from the batter (those things are too light! the wind takes them!) so I developed a very nice aim-throw-duck habit. Some of those kids can seriously slug the ball, even though they can only hit it if it's in the exact same place every time.

...

Last week one of my coworkers made the suggestion that if I got a third roommate, I could rent a townhouse and live someplace nicer for less money (but more interaction). I've almost convinced another coworker that she wants to live with us, so we checked out a place last night. It was so cute. The first floor has a living room, dining room, kitchen, half-bath, and garage, then upstairs there's a master bedroom with bathroom, two smaller bedrooms, another bathroom, a laundry room, and a kind of central gathering area. Good location, pretty new, great price. Also it's painted really pretty colors. So I very much want this house, but my coworker is still waffling (not that I blame her; I only suggested this yesterday). I have the realtor's phone number and if we move we'll probably get it... think good house thoughts for me!

# : 3:07 PM : :

I'm flying into Cleveland tonight. There's a family party sometime over the weekend (I don't know which day; no one tells me anything) but I'm definitely free Friday night. I'm thinking about hanging out at Mi Pueblo and possibly doing something else before or after. My other big plans are seeing Harry Potter and the Prisoner of Azkaban and cuddling my kitties. It'll be a good weekend.

Clevelanders, call my cell or email if you want to hang out!

# : 3:22 PM : :

Last night I had a bad dream. There were a lot of scary things that happened in it, but the one that woke me up and wouldn't let me get back to sleep was that I got a bad score on the MCAT.

Hi, my name is Amanda and I'm a pre-med.

Every day, I wonder when my MCAT scores will be posted. I feel like I'm behind because I haven't submitted my AMCAS application yet (today is the first day they were accepted). I want someone to proofread it first (it's a giant online form). And I haven't finished my personal statement because I'm doing the procrastinating-perfectionist thing. (As long as I don't finish it, I can believe that it'll be spectacular whenever I finally do. But if I write a final draft, I have to accept the imperfections.) Also, I'm debating whether I should wait for my MCAT scores before I submit. I am pretty sure that's silly, but, you know, I'm a nut.

# : 8:49 AM : :